Oscillometric measure of blood pressure detects association between orthostatic hypotension and depression in population based study of older adults.

BACKGROUND: White matter hyperintensities may contribute to depression by disrupting neural connections among brain regions that regulate mood. Orthostatic hypotension (OH) may be a risk factor for white matter hyperintensities and accumulating evidence, although limited suggests it may play a role in the development of late-life depression. The aim of this study was to examine the relationship between an oscillometric measure of orthostatic hypotension and depression in population based sample of older adults. METHODS: We analysed data on adults aged 60 and over from the first wave of The Irish Longitudinal Study on Ageing (TILDA). Depression was assessed using the Center for Epidemiologic Studies--Depression (CES-D) scale and OH was assessed by a sit-to-stand orthostatic stress test; two seated blood pressure measurements were followed by a single standing blood pressure measurement. Participants self reported whether they felt dizzy, light-headed or unsteady on standing. RESULTS: Participants with symptomatic OH (SOH, n=20) had the highest mean CES-D score (mean 8.6, SE 1.6) when compared to participants with asymptomatic OH (AOH) (mean 5.6, SE .48) and participants with no OH (mean 5.2, SE .14) and this difference was significant for both comparisons (p<0.001). Linear regression analysis adjusted for socio-demographic and clinical characteristics showed that SOH was associated with higher CES-D scores (unstandardised B coefficient = 2.24; 95% CI .301 - 4.79; p =0.05) compared to participants without OH. AOH was not associated with higher CES-D scores (unstandardised B coefficient =.162; 95% CI -.681, 1.00; p= 0.70). CONCLUSIONS: Symptomatic orthostatic hypotension is associated with depression in older adults and needs to be considered in studies examining the relationship between vascular disease and depression in older adults.

Age and sex differences in prevalence and clinical correlates of depression: first results from the Irish Longitudinal Study on Ageing.

OBJECTIVE: The risk of depression is increased by physical illness; however, the nature of this relationship is complex and unclear. Here, we explore the prevalence and clinical correlates of depression, with particular emphasis on factors representing consequences or physical manifestations of disease and identify age and gender differences in their effects. METHODS: A population-representative sample of 8175 community-dwelling adults aged 50 years and over participated in the first wave of The Irish Longitudinal Study on Ageing. The primary outcome measure was clinically significant depressive symptoms defined by a score of 16 or greater on the 20-item Centre for Epidemiologic Studies Depression scale. RESULTS: Overall, 10% (95% CI: 9-11%) of adults reported clinically significant depressive symptoms. Physical illness is associated with depressive symptoms only in adults 65 years and older; in adults aged 50-64 years, the association is mediated by medication use, and this age difference is statistically significant (p < 0.00). Irrespective of age, chronic pain and incontinence were stronger predictors of depression in men (interaction effects p < 0.00) CONCLUSIONS: Our findings identify age-specific and gender-specific clinical markers for depression risk among the older population, which may identify those more likely to present with depression in community settings.